Isle of Wight Council

COVID-19 Local Outbreak Management Plan 2021

Version 1.0 Final

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Foreword

In line with the next phase of the UK’s response to the COVID-19 pandemic, the Council (IWC) is required to review and update the Local Outbreak Plan. This 2021 update plan details how the Council and its partners will respond to further outbreaks of infection and covers the key aspects. The full IWC Incident and Outbreak Control Plan can be found on the IWC Outbreak Management webpage.

Our aim

We want Isle of Wight residents to be able to live healthy and productive lives. But we need to achieve this in a way that is safe, protects our health and care services and enables the local economy to restart and thrive as we manage the response to the COVID-19 pandemic and learn to live with COVID-19.

We aim to:

• Reduce the transmission of COVID-19, protecting all, especially those who are most vulnerable, and preventing increased demand on our health and care services. • Provide consistent advice to places and communities to prevent the spread of COVID-19. • Oversee the NHS test and trace programme on the Isle of Wight and its working with the Isle of Wight Local Tracing Service, and coordinate testing across the Island. • Oversee the implementation of the local COVID vaccination programme across the Isle of Wight. • Work together with partners, in a coordinated way, to support communities across the Island to reduce the spread of infection and ensure that the most vulnerable have access to the support they need.

This Local Outbreak Management Plan should be read in conjunction with the IWC COVID-19 Prevention, Incident and Outbreak Control Plan and settings based action plans available on the IWC website.

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Document Control

This plan is authored and maintained by Isle of Wight Council Public Health.

Version Date Remark(s) Author 0.1 11/03/2021 Initial draft SB (draft) 0.2 15/03/2021 Updated with additional information SB/ BH (draft) 0.3 25/03/2021 Updated with additional information SB/BH (draft) 1.0 30/03/2021 Updated with additional information SB FINAL

Date Published: 31/03/2021

Document Review

The IWC COVID-19 Outbreak Management Plan 2021 will be reviewed on a quarterly basis unless learning from an incident or outbreak requires it to be reviewed sooner. The original IWC COVID-19 Prevention, Incident and Outbreak Control Plan remains available on Council website for reference.

Document Distribution

• Isle of Wight Council GOLD • Members of the Isle of Wight Local Outbreak Engagement Board • Members of the Isle of Wight Health Protection Board • and Isle of Wight Integrated Care System • Hampshire and Isle of Wight Local Resilience Forum • Isle of Wight Health and Wellbeing Board

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Contents Page

Foreword ...... 2 Document Control ...... 3 Contents Page ...... 4 Section 1 – Background information ...... 6 1.1 Isle of Wight Context ...... 6 1.2 COVID-19 objectives ...... 6 1.3 Governance ...... 8 1.3.1 IWC COVID-19 Local Outbreak Engagement Board (LOEB)...... 9 1.3.2 IWC Health Protection Board ...... 10 1.3.3 Hampshire and Isle of Wight Local Resilience Forum ...... 10 1.5 Local authority and public health protection powers ...... 11 Section 2 – the COVID-19 Response ...... 12 2.1 Adult care settings including care homes ...... 12 2.2 Schools, education and childrens’ care settings ...... 12 2.3 High risk places, locations, communities and healthcare settings ...... 13 2.4 Local testing programmes ...... 14 2.4.1 Asymptomatic testing at scale ...... 15 2.4.2 Optimising testing capacity ...... 15 2.5 Contact tracing ...... 16 2.5.1 Enhanced contact tracing...... 16 2.5.2 Designated Venues ...... 17 2.5.3 Local tracing partnerships ...... 17 2.6 Self Isolation ...... 18 2.7 Vulnerable people ...... 19 2.8 Outbreak management and Variants of Concern ...... 20 2.8.1 Surge capacity management locally to respond to outbreaks, including of a (VOC) . 21 2.9 Enduring transmission ...... 22 2.10 COVID safe ...... 22 2.11 Vaccinations...... 23 2.11.1 Measures to improve vaccine uptake locally ...... 23 2.11.2 Linkages between vaccine roll-out and testing ...... 24 2.12 Compliance and enforcement ...... 24

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2.13 Communications and engagement ...... 25 2.14 Surveillance ...... 26 2.15 Resourcing ...... 28 2.15.1 Capacity management ...... 28 2.15.2 Management of impacts of the resumption of business as usual activities ...... 29 Section 3 Forward Planning ...... 30 Appendix 1 – List of Acronyms...... 32 Appendix 2 – Roles and Responsibilities ...... 33

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Section 1 – Background information

1.1 Isle of Wight Context

The Isle of Wight lies off the south coast of mainland and covers an area of 380.16km2 (38,016 hectares, or 146.8 sq. miles). Newport, the second largest town by population, is the administrative centre, and is home to the Isle of Wight Council, St. Mary’s Hospital, courts and strategic command centres. The Isle of Wight has 39 Electoral Wards and 33 Town and Parish Councils.

This plan, and the original IWC COVID-19 Prevention Incident and Outbreak Control Plan 2020 , identifies those at high risk of COVID-19 such as those over 70, from ethnic minorities or living with long term conditions. It also provides an understanding of high risk settings in the area (for example prisons and care homes) and identification of those populations who are least likely to access services, such as people from ethnic minority groups, people living in areas of deprivations or those not registered with a GP.

IWC produce COVID-19 data packs which comprise of the latest information available from open sources related to COVID-19. The IWC, and its partner agencies, can use these packs to understand the potential population health needs, risks and vulnerabilities which exist within their own areas. The packs also includes information related to schools and care homes which are themes within the Local Outbreak Control Plan. In light of the 2nd wave of COVID-19 and the high transmissibility of the new variant, the data pack will be updated to include high risk settings such as HMP Isle of Wight.

1.2 COVID-19 objectives

The main objective in managing an outbreak is to protect the public’s health. In the situation of a COVID-19 outbreak, this will mean taking action to ensure those infected self-isolate, contacts are traced, and measures are implemented to stop further spread or recurrence of the virus and mobilise the support for our most vulnerable residents to maintain their health, care and support needs. Information, targeted to both staff in agencies and members of the public is available on the Keep the Island Safe website.

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We have followed government guidance, and our Local Outbreak Control Plan has a number of key components.

These are identified below and shown in more detail in section 2 – planning themes:

• Adult care settings including care homes • Schools, education and children’s’ care settings • High risk places, locations and communities • Local testing • Contact tracing • Self-isolation • Vulnerable people • Outbreak management and Variants of Concern • Enduring transmission • COVID safe • Vaccinations • Compliance and enforcement • Communications and engagement • Surveillance • Resourcing

The IWC will continue to work with partners including the Department of Health and Social Care (DHSC) and Public Health England (PHE) to:

• Take a system view of issues and develop a joint understanding of the local context: ensuring even greater coordination and coherence of our response, a commitment to working across teams to understand impacts at a local level and planning ahead from a shared set of assumptions. • Engage, involve and inform our communities: building a positive narrative as we continue to manage our response that reassures people and enables them to feel optimistic about the future and clear about the expectations of them – with more support for locally tailored communications and local decision making that recognises the diversity of local communities. • Pool and share resources, evidence and data: ensuring we are using and sharing our combined resources efficiently, effectively and more systematically, so our

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response continues to adapt to the latest evidence and good practice to deliver our shared goals of living safely with COVID-19.

1.3 Governance

This section provides an overview of the governance arrangements that have been established to develop and deliver on the objectives of this Plan. This is illustrated in Figure 1 below with further detail provided in subsequent paragraphs. More detailed information on the governance and meeting structure is contained in the full IWC Outbreak Control Plan published on the IWC website. Further information on roles and responsibilities can be found in appendix 2.

Governance Reporting for the Health Protection Board (HPB) is currently as shown in the diagram below. A risk register for the Board is maintained and reviewed regularly and risks identified by the Outbreak Control Working Group (OCWG) are formally escalated to the COVID-19 HPB via the OCWG Chair. Changes in the governance structure to bring the governance of COVID-19 testing and the Local Tracing Partnership more formally under the Outbreak Management governance structure are currently being agreed.

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Figure 1. Governance Structures

1.3.1 IWC COVID-19 Local Outbreak Engagement Board (LOEB)

The IWC COVID-19 Engagement Board (LOEB) is a member-led oversight board, chaired by the Leader of IWC. The LOEB is a subgroup of the IWC Cabinet. The primary roles of the LOEB are to have political oversight relating to COVID-19 incident and outbreak response, and to provide direction and leadership for community engagement and be the public face of the local response in the event of an outbreak. In line with the guidance we have further strengthened the accountability to the Health and Wellbeing Board.

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1.3.2 IWC Health Protection Board

Under the leadership of Director of Public Health (DPH), the IWC COVID-19 Health Protection Board (HPB) is responsible for the delivery of the plan. Membership of the HPB includes the IWC Chief Executive, IWC Directors (including Adults’ Social Care, Childrens’ and Communications), Public Health England (PHE), the NHS and Police. This partnership is instrumental in managing the local response to the pandemic and by continuing to work together through this Board, we will ensure the needs of the Island residents are met and that the incidence of cases is lowered and lives saved. The HPB will continue to oversee COVID-19 prevention and outbreak response. The HPB will also monitor recovery activities, as well as the ongoing and emerging needs of the community as a result of COVID-19.

The membership and terms of reference of the Board will be reviewed regularly to reflect the requirements of our ongoing work as our response moves into recovery and beyond.

1.3.3 Hampshire and Isle of Wight Local Resilience Forum

IWC continues to be an integral partner within the Hampshire and Isle of Wight Local Resilience Forum (HIOW LRF) and have actively supported the command and control structure with representatives in the core groups including the Strategic Coordinating Group (SCG), Island Partners Activation Teleconference (IPAT), or Island Tactical Coordinating Group (ITCG) and Recovery Coordinating (RCG).

As the pandemic progresses, the requirement for the various cells of the HIOW LRF command and control structure needs to change. At this stage in the response, a number of the HIOW LRF command and control cells have stepped down including the SCG and TCG. There are however some key workstreams from previous cells that will need to continue for the foreseeable future, these include media, compliance and enforcement, testing and tracing. In order to ensure oversight of these key workstreams they will now feed into the Pan Hampshire Health Protection Collaborative Forum (PHHPCF) who will report any issues up to the four HPB’s as required.

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1.4 Local authority and public health protection powers

Island residents have acted responsibly to protect their own and other people’s health and we envisage that this will continue with everyone playing their part. However, occasionally voluntary measures are insufficient and legal powers are needed to deal with infections or contamination that present a significant risk to human health. The powers that are available to IWC to protect the public’s health are detailed within the IWC Incident and Outbreak Control Plan. Any exercise of these powers can be used in consultation with other organisations, such as Public Health England’s Health Protection Team, the NHS or the emergency services.

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Section 2 – the COVID-19 Response

2.1 Adult care settings including care homes

Measures have already been put in place in care homes to prevent the risk of infection, but we need to be ready for any potential outbreaks. There are 6 key objectives for supporting care homes throughout the COVID-19 response, these are listed in the below bullet points and are taken from the COVID-19 Care Home Support Plan for the Isle of Wight:

• Ensure that the care provided is of a high standard and is able to meet individual needs safely. • Support care providers in order for them to remain viable now and beyond the COVID-19 pandemic. • Ensure that care providers receive the specialist clinical advice to support the health of their residents. • Ensure appropriate provision of testing, availability of Personal Protective Equipment (PPE) and excellence in IPC practice. • Allocate funds in a fair and transparent way and continue to review financial support. • Provide access to the most up to date information in easily accessible formats.

IWC will continue to monitor the local situation through data integration and information sharing (see section 2.13), so that we can quickly identify actions needed to manage an outbreak and protect lives. Action plans for adult care settings are available on the IWC website . and include: • Care homes • Supported living, extra care and shared lives • Domiciliary care/ home care • Day services including mental health • Direct payment users

2.2 Schools, education and childrens’ care settings

Measures have already been put in place in schools to prevent the risk of infection, but we

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need to be ready for any potential outbreaks. There are a large number of early years settings, schools and independent schools on the Island.

Along with PHE Health Protection Team (HPT), IWC will continue to monitor the local situation through data integration and information sharing (see section 2.13), so that we can quickly identify actions needed to manage an outbreak and protect lives. A full list of education and children’s care settings, including their relevant action cards, can be found on the IWC Website and in the IWC Incident and Outbreak Control Plan.

IWC will continue to work with health and education to support staff in early years, primary, secondary schools and colleges and secondary school pupils to undertake testing twice a week at home to help to break the chain of infection. This is supported the wider testing strategy to an accessible testing offer through asymptomatic testing sites and the availability of tests for collection for childcare and household bubbles, as detailed in section 2.4.

Further information, guidance and advice on managing COVID-19 in these settings are available on the Keep the Island Safe website. Action plans for Childrens’ Education and care settings are available on the HCC website and include:

• Educational residential settings • Schools and educational settings

2.3 High risk places, locations, communities and healthcare settings

Working with the NHS and other partners, we have identified locations and communities that may be at greater risk from COVID-19 outbreaks. These include a wide range of places such as transport hubs, tourist venues, prisons, hospitals, hospitality and tourism outlets and higher risk workplaces. On the Island we take a dynamic approach to considering which settings could be high risk to take account of how venues are accessed and utilised in line with changes in government guidance and seasonal fluctuations, for example, hospitality and tourism outlets are more likely to be accessed when restrictions have eased, and during school holidays and the summer months. Where a setting is considered to be at higher risk of outbreak and infection

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spread, IWC leads will work with the setting to explain how we will tackle any outbreaks within these locations and who else will be required to help us.

We have established close links with settings of national strategic importance and worked with them to ensure they are confident in how to access support in managing outbreaks and community testing.

Action plans for high risk settings and locations are available on the IWC website. and include: • Health settings, workplaces, detained settings and further education • Transport hubs and public facilities • Housing, holiday and tourist settings • Faith and community settings • Events Further information, guidance and advice on managing COVID-19 is available on the Keep the Island Safe website.

2.3.1 Events

IWC are working closely with partners and the other Upper Tier Local Authorities in Hampshire to ensure consistency in managing events that may be permitted later in 2021 as the Government COVID-19 road map comes to fruition. Along with IWC’s Environmental Health leads, the Council’s Public Health and Emergency Planning teams review escalated event applications, COVID-19 risk assessments and event management plans to ensure they are in keeping with Government guidance and include sufficient COVID-19 mitigation measures.

Further information, guidance and advice on managing COVID-19 is available on the Keep the Island Safe website for businesses and event organisers.

2.4 Local testing programmes

We aim to ensure testing can be accessed easily by all our residents. On the Isle of Wight access for testing for residents with COVID-19 symptoms is provided via the NHS website,

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or by telephoning 119 to arrange to be tested at the regional testing site, or via a home testing kit. Information is provided that describes how local testing will be used to ensure a swift response is provided to any suspected cases or outbreaks. Targeting communication for places which have been identified as higher risk we have also summarised to ensure how they can access testing for their staff and residents.

2.4.1 Asymptomatic testing at scale

We know that COVID-19 can be passed from individuals who are asymptomatic and therefore unaware that they are infectious. In order to reduce transmission across the Island, in addition to existing national workplace based schemes, asymptomatic community testing sites have been set-up to offer testing for any Island resident who is having to leave their home for essential reasons. This is offered either through a collection at the Regional Test Site (RTS), through attendance at community testing sites or through the national home ordering system or through community collect. The testing offer has been supported by tailored communications to engage with target groups and those who may be harder to reach, through a number of media channels and specific engagement with partners across the Island and in local business.

2.4.2 Optimising testing capacity

IWC will develop our testing plans based on the needs of the population and in line with government guidance. We are working with the DHSC to improve coverage of community testing across the Island until June 2021, both through the collection of home testing kits and attendance at asymptomatic testing sites. This includes a review of current asymptomatic testing sites, with some existing sites repurposed as dual Asymptomatic Testing Site (ATS)/ Community Collect. We will set up new ATS to increase geographical coverage and reduce barriers vulnerable groups and those who are less likely to access testing, including people from ethnic minorities and higher risk occupations. This offer will be achieved, for example through setting up smaller versions of the current ATS; this is likely to include pharmacies. We will explore workplace testing for public sector workers to ensure coverage for our frontline health and social care workers where not covered elsewhere, demonstrating the leadership of the public health authority.

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The testing strategy is supported by tailored communications to ensure improved awareness and uptake for people with and without symptoms.

2.5 Contact tracing

Contact tracing is a fundamental part of the IWC COVID-19 Prevention, Incident and Outbreak Control Plan. Contact tracing is a proven method of disease prevention and control used for many years by public health experts. The aim of contact tracing is to identify and provide support to people ('contacts') who may have been infected through exposure to another infectious person. Providing residents with access to prompt and convenient testing, and ensuring their close contacts are traced, is key to preventing further spread of the virus by breaking the chain of infection.

When a person tests positive for COVID-19, they are contacted to gather details of places they have visited and people with whom they have been in contact. Those who are identified as a ‘close contact’ are then contacted and given advice on what they should do e.g. self- isolate. Contract tracing will usually be carried out by the NHS Test and Trace service. IWC has its own Local Tracing Service that works closely with the NHS Test and Trace service to ensure reach and communication links are made with local communities and Island residents.

2.5.1 Enhanced contact tracing

Outbreak Investigation and Rapid Response (OIRR), previously known as enhanced contact tracing, is a systematic approach to gathering and analysing contact tracing data and other locally available information in order to rapidly detect and risk assess potential new COVID-19 case clusters locally. Test and Trace collect backward contact tracing data from people who have tested positive for COVID-19 to help identify where and when they were likely to have been infected.

Information from contact tracing questionnaires is used to identify common exposures among cases, places and events that have been named by multiple cases as a potential source of their infection. Locations that multiple cases visited while infectious are detected in postcode coincidence reports and these are reported to HPTs.

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HPTs will use various data streams including common exposure reports and postcode coincidence data to produce a report for Local Authorities giving details of outbreaks and linking this to previous contact tracing data. This report will detail the action carried out by the HPT and determine if further follow up is required at a Local Authority level. Local teams will risk assess these to confirm if there is a cluster/ outbreak and determine what public health action needs to be taken. In addition, this report is used by the app team to send out a warn and inform alert to other people who attended the place or event to notify them that they may have been exposed to the virus. When required we will work with the local HPT to undertake enhanced contact tracing in high risk venues using the test and trace staff.

2.5.2 Designated Venues

Designated venues are legally required to request and maintain customer, visitor and staff contact details and display an official NHS QR code poster. Should an outbreak occur at a venue, this will support NHS Test and Trace to be able to contact those who are at potential risk of COVID-19 and give them the necessary public health advice. This advice will come via a ‘warn and inform’ or ‘get a test’ message via SMS or the NHS COVID-19 app. The Local Authority will receive daily reports when a venue alert has been generated in our area. We will review this data at our daily data meeting alongside other intelligence and liaise with our colleagues across the Council.

2.5.3 Local tracing partnerships

A locally supported contact tracing system is an initiative to help prevent further spread of infection local areas from entering national or local mitigation measures and would allow local control over case completion rates from the national system, with the aim of increasing the proportion of cases traced through local engagement. The IWC has worked in partnership with Public Health England and LRF partners to establish its own locally supported contact tracing partnership, known as the Isle of Wight Local Tracing System. with the aim of increasing the proportion of cases traced through local engagement.

Additional advantages of locally supported contact tracing include a higher potential for cases with incorrect contact details to be tracked using locally held contact details and a

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higher likelihood of cases responding due to the use of local telephone numbers and call- back facilities.

In practice this means:

• Where the NHS Test and Trace service is unable to reach people, who have tested positive for COVID-19 (cases) within their usual timeframes, local call handlers take over. • The local call handlers then attempt to contact cases to gather details of their close contacts. This is achieved through a variety of methods including text messaging, and a call from a local phone number. • When contact is made, the case is asked about their movements in the days prior to the start of symptoms, or a positive test and asked to provide relevant information about close contacts. This information is then shared with the national Test and Trace team to enable them to follow-up the contacts. • The local call handlers also offer advice on local support that is available to self- isolate if required, as well as picking up on any welfare, wellbeing or safeguarding concerns. • Processes are in place to escalate safeguarding concerns appropriately.

The Local Tracing Service therefore plays a crucial role in protecting our communities on the Isle of Wight and the LTP will continue to develop in line with National policy to ensure that we provide the best service to support our residents and to break the chain of infection.

2.6 Self Isolation

Self-isolation is an integral part of the COVID-19 response ensuring that individuals who have COVID-19 or are at high risk of having the virus through contact with an index minimise the risk of exposing others to infection and new variants. The IWC plays a critical role in raising awareness of and supporting self-isolation to ensure high levels of compliance with self-isolation for people who test positive for coronavirus and their close contacts. Our effective approach to ensuring high levels of adherence to self-isolation in accordance with the Self-Isolation guidance issued to local authorities in March 2021 involves the following elements:

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• Communications – understanding of self-isolation requirements and importance • Practical, social and emotional support • Financial support • Targeted enforcement – where breaches of legal requirements evident

It is anticipated that most people who need to will be able to self-isolate for the maximum two- week period without any support. However, we know that some residents will need extra help to support them while they self-isolate. Through its helpline and its joint working with community groups and hubs, the IWC will continue to provide support, both financial and practical, to Island residents when this is required.

IWC continues to work closely with residents identified as Clinically Extremely Vulnerable (CEV) to provide them with support throughout their shielding periods. Communication with this cohort has been via letters and telephone calls to keep residents up to date and informed on the support available to them. For Island residents who are self-isolating, IWC continues to promote self-isolation support through national processes to financially assist those individuals who are eligible for this scheme. The IWC Coronavirus Helpline is a one stop shop for all Island residents to offer social and practical support delivered in partnership with local community hubs, charities and other voluntary organisations.

2.7 Vulnerable people

It has been identified that certain communities and individuals on the Island are more vulnerable to harm from COVID-19. Different factors contribute to this vulnerability, some of which have become evident in how individuals and communities respond to and recover from the virus.

The Island has established 27 Community Hubs set up by local Town & Parish council’s or other voluntary community groups. These groups have been supported by Community Action IW in terms of locality support and sustainability considerations. The council supports the Community Hub Forum group to provide two way engagement and sharing of information with emerging needs in communities and the means in which to coordinate support.

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To help us understand the potential direct and indirect impact COVID-19 may have on our communities during the different stages of the pandemic, three separate indices have been developed. These can be used to inform the range of approaches the local authority may employ to prevent the further spread of the virus and manage outbreaks. These indices are:

• Clinical vulnerability to COVID-19: those at higher risk of experiencing severe outcomes from contracting COVID-19 • Wider risks from COVID-19: the increased risk of contracting COVID-19 through work and living conditions • Vulnerability to policies relating to COVID-19: the increased risk of experiencing negative impacts from COVID related policies, e.g. lockdown or economic downturn

For more detailed information on the vulnerable populations across the Island, please see the Isle of Wight Joint Strategic Needs Assessment pages and the IWC COVID-19 data packs.

2.7.1 Shielding

During any national pause on shielding advice, the Local Authority will remain responsible for maintaining a contingency plan to stand up support to those identified as CEV. In the event of a major outbreak or Variant of Concern (VOC) that poses a significant threat to individuals on the Shielded Patient List (SPL), re-introduction of shielding can occur by agreement of Ministers. If agreed, shielding notifications would be issued by post to all people on the SPL in an affected area.

2.8 Outbreak management and Variants of Concern / Variants under Investigation

The local response to a COVID-19 incident or outbreak in any setting or multiple settings requires robust processes for notification, incident, and outbreak management, and may require collaborative work with other agencies. The Outbreak Control Plan provides Standard Operating Procedures for how the IWC team will respond to an outbreak of COVID-19 working with partners both internally, locally, e.g. the NHS, and nationally, e.g. Public Health England. Throughout the response to COVID-19, additional staff have been upskilled to provide additional support to respond to

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outbreaks of COVID-19 and to support the response to an identification of a Variant of Concern (VOC). While the response to a VOC or Variant Under Investigation (VUI) will use many of the same approaches as the response to other forms of outbreak, the risk from VOCs or VUIs can be greater and therefore the response may need to be carried out at a far greater pace and scale. Further information including a more detailed explanation on how the IWC works with partners to detect outbreaks and clusters, and the roles and responsibilities of the IWC local teams is outlined in the IWC Incident and Outbreak Control Plan.

2.8.1 Surge capacity management locally to respond to outbreaks, including of a Variant of Concern (VOC)

The IWC has developed a Surge Testing plan to enable a quick time, targeted response to the identification of a new Variant of Concern (VOC). The plan has not had to be utilised to date but where appropriate would be deployed and implemented in partnership with partners including the DHSC and Public Health England, as well as local partners to ensure a targeted and proportionate response. When planning for a surge testing there are clear elements to be identified:

• Area for testing and the parameters, i.e. residential only, if schools or commercial properties are included • The best method for conducting the investigation of the VOC / VUI Consultation with local staff/councillors and the public to support communication • A base of operations that can be hired for the duration of the period if required • Logistics and consumables required, including utilising resource from LRF partners and the voluntary and community sector where appropriate.

The plan includes establishment of a local OCT in partnership with HIOW HPT as well as a tactical group to obtain and coordinate resources, linking with LRF partners through existing structures when these are stood up or through a partner activation conference as appropriate. Once the surge testing area and timelines are agreed, a small on-site operational group can be set up at short notice to coordinate delivery. A suite of practical resources has been established to enable this, including written briefing for those delivering door to door test kits.

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2.9 Enduring transmission

In some areas transmission of COVID-19 has remained high and above the national average for long periods of time, resulting in increased levels of infection persisting for many months with the result that restrictions remained in place, this is referred to as enduring transmission. Evidence gathered by NHS Test and Trace suggests that, while there is no single cause of enduring transmission there are a range of inter-connected factors related to enduring transmission including;

• Deprivation (including un-met financial need) • Employment and occupation • Demographics and household composition • Attitudes and behaviours • Response

The Isle of Wight is among the more deprived authorities in England according to the Index of Multiple Deprivation 2019, ranking 80th most deprived of the 312 Lower Tier Authorities in England. There are pockets within the Isle of Wight that fall within the most deprived 20% in the country. Levels of unemployment, as measured by the claimant count in February 2021, are higher on the Isle of Wight than in the South East or nationally. The Isle of Wight has high concentrations of elderly residents and is also relatively reliant on shut-down sectors such as tourism and hospitality.

The factors outlined above can be considered as social vulnerabilities. Information related to demographics, population, the economy and deprivation are available to all partners via the Public Health JSNA website Our Community (iow.gov.uk).

2.10 COVID safe

For the foreseeable future we will need to maintain Non-Pharmaceutical Interventions (NPIs) to reduce the risk of infection. Examples of this include handwashing, using face coverings and maintaining adequate social distancing as well as ensuring there is adequate ventilation in indoor settings. To enable these interventions to continue to be successful with

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our communities we will continue to monitor social attitudes and adapt communications accordingly.

Focus on NPIs has been an important and constant part of the comms strategy. We have used national PHE assets, localised assets and social media engagement amongst others to embed these behaviours. ‘Hands, face, space’ is a key message that continues to be embedded in all ‘Keep the Island Safe’ campaigns: it is included in all digital and offline assets, promotional materials such as leaflets and posters, stakeholder briefings and newsletters, and press releases.

2.11 Vaccinations

The COVID-19 vaccine is a safe, effective way to protect ourselves from Coronavirus. IWC are working closely with NHS England, the IOW Trust, the IOW Clinical Commissioning Group (IOW CCG), and other partners across the HIOW LRF footprint to support the successful roll-out of vaccinations. IWC are also working closely with our Communications Team to encourage uptake of the vaccine across Island residents and to provide clear information on the vaccine so that residents feel fully informed ahead of receiving the vaccine. It is important to continue providing testing for symptomatic and asymptomatic people across the Island alongside the vaccine roll-out to continue to protect the most vulnerable in our society and those who are not yet eligible for the vaccine. More information about the vaccine and when you will be contacted is available on the Keep the Island Safe website.

2.11.1 Measures to improve vaccine uptake locally

In partnership with our public health colleagues in other local authorities we have identified, from the evidence, groups at lower risk of uptake. This has included groups in high risk settings, higher risk groups in community settings and other groups of concern. We have proposed measures to reach and vaccinate these groups. We are now working at pace with the IOW CCG to help refine strategies to maximise uptake, using evidence of effectiveness and emerging data. Actions taken to date to improve the levels of local vaccine uptake in higher risk groups include;

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• Roll out of the vaccination programme in line with directions from NHSE Health in Justice commissioners in HMP IOW Prisons. • Vaccination of residents in learning disability homes. • Vaccination of learning disability clients living in the community. • Vaccinating carers in receipt of carers allowance and unpaid carers, including communications with this group to encourage registration of the carer status with their GP. • Working with the IOW Trust to identify and promote vaccination amongst clients with mental health needs.

The IWC and IOW CCG will also engage with faith groups, mosques, substance misuse providers, homeless accommodation providers and other community action groups to determine the feasibility of a holding pop-up clinics for vaccination.

2.11.2 Linkages between vaccine roll-out and testing

IOW have ensured that our messaging on vaccination and testing is cohesive and consistent. With our communications we have ensured that people who have been vaccinated still access testing. Once the vaccination roll-out expands we will use our testing sites to promote vaccine uptake. We are aware that the inequalities seen in take-up of testing also apply to uptake of vaccination; we will ensure we apply learning across the programmes.

2.12 Compliance and enforcement

As with all elements of our Outbreak Control response, the responsibility to ensure compliance with regulations and restrictions is shared across a number of enforcement agencies.

Local Authority Regulatory Services along with Hampshire Constabulary have primary responsibility to enforce and regulate the coronavirus restrictions. They seek to engage, explain, encourage and only then enforce against businesses and individuals for breaches of regulations associated with COVID-19.

The IWC Regulatory services have a number of priorities relating to regulatory covid-19 activity as specified by the Ministry of Housing, Communities and Local Government (MHCLG). All

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compliance and enforcement activity is in line with local enforcement policies and the Local authority compliance and enforcement good practice framework produced by the MHCLG.

As part of the government surge funding for enforcement and compliance, the Isle of Wight has established a joint Management and Compliance action group as part of the LRF and silver response. This is a multi-agency group which identifies local priorities and emerging issues around compliance and enforcement as well as providing regular statistic updates on enforcement activity to the government. The cell actively engages with the business sector and local communities to promote compliance as well as public transport providers such as the cross Solent operators.

Part of the funding has also enabled the recruitment of COVID-19 support officers who support both the Local Authority Regulatory teams and wider COVID-19 response in providing advice, guidance and support.

It is anticipated that further legislation changes are likely over the next year and compliance with these changes are vital to controlling the transmission of infection. The Management and Compliance group will continue to work in partnership to focus on compliance ensuring an effective and consistent approach thereby maintaining public trust and confidence.

In addition to this the Isle of Wight Safety Advisory Group has put in place additional measures to ensure event organisers have appropriate advice and guidance on how to ensure compliance with COVID-19 guidelines. As restrictions ease and events can take place this will be a key workstream where partnership working between IWC departments, HCC Public Health and the emergency services across the Island is crucial.

2.13 Communications and engagement

Public engagement and trust is crucial to the response to COVID-19. The IWC Communications Team work closely with multi-agency partners both on the Island, and across the Hampshire and Isle of Wight Local Resilience Forum (HIOW LRF) area to ensure consistent messaging and information sharing. Key to the success of managing COVID-19 is that residents and businesses understand national guidance and messaging and that these messages are shared widely and are accessible to all Island residents. Community resilience is maximised by involving our voluntary and community services and community hubs to be at the heart of local communities and support the engagement with those we serve from a

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collective and consistent information sharing.

The IWC Health Protection Board has developed a communications strategy specifically for COVID-19 management. This strategy is regularly reviewed to ensure that it reflects our ongoing management of the pandemic and is updated to include our evolving approach to engaging communities on the Island.

Local communications have included but not limited to: • Advertising and interviews on local radio • Organic posts, targeted paid for posts and engagement on social media • Regular residents e-newsletter • Print – posters, leaflets, adverts • Stakeholder Engagement

Throughout the pandemic Isle of Wight Council has worked closely with its stakeholder network of local business leaders, faith leaders, Visit Isle of Wight, Chamber of Commerce, cross-Solent travel operators to share and cascade public health messages. Sharing messages at a high level creates a sense of community collaboration as the key messages spread themselves via stakeholder’s own networks.

Core messaging throughout the COVID-19 pandemic has focussed on the importance of Non-Pharmaceutical Interventions (NPIs) such as hands, face, space, not undertaking unnecessary travel and working from home where possible. These messages have constantly been refreshed by the IWC Communications Team to ensure they remain in line with key national messages and also encouraged continued public support.

2.14 Surveillance

Surveillance will continue to play a critical role in preventing and responding to outbreaks. The current arrangements for surveillance, data integration and information sharing on the Island and with our partners are as follows.

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• Population Health, Intelligence and Modelling Cell - The HIOW LRF Population Health, Intelligence and Modelling Cell has successfully used a public health approach to model the spread of COVID-19 infection across the HIOW population. This modelling work has fed directly into the LRF Response and Recovery structure, and more recently the Pan Hampshire Health Protection Collaborative Forum to support decision making by providing a range of scenarios based on the best available epidemiological evidence. From November 2020 and in recognition of the increasing complexities such as the rollout of the vaccination programme and new variants, a new model was adopted which builds on the work and Medway developed. The model uses the epidemiological evidence that we know of COVID- 19 and simulates infection spread through a population, it also models the impact on our population of the new variant, social distancing compliance and the vaccination roll out and effectiveness. • Data Compendium - Public Health analyst teams across the Island have worked collectively across the LRF throughout the response to COVID-19 to deliver intelligence products efficiently through sharing resources and avoiding duplication of effort. This integration is evident in the HIOW LRF COVID-19 Compendium, which distils the increasing amounts of COVID-19 intelligence that are available into one place. It provides an overview of the impact of COVID-19 across the LRF system, with data also presented at more local geographies where appropriate and possible. • Early Warning Indicators Dashboard - Public Health analysts reporting to the HIOW LRF Population Health, Intelligence and Modelling Cell have produced an Early Warning Dashboard that is presented as a separate product in a PowerBI report and reviewed on a regular basis. • Joint Biosecurity Centre (JBC) Playbook - The JBC, which has the role of bringing together data from testing and contact tracing, alongside other NHS, and public data, will provide insight into local and national patterns of transmission and potential high- risk locations, and identify early potential outbreaks so action can be taken. The JBC will act as an independent analytical function to provide data and analysis to government and to local authorities, helping to identify and respond to outbreaks as they occur and trends for early warning. • Local PowerBI dashboard - Data from a range of sources, as outlined above is used to populate a local PowerBI dashboard on a daily basis. This local dashboard

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provides information on trends and locations of cases, rates of positive tests, demographics of cases and outbreaks which is used to form the Weekly COVID-19 dashboard. • Wastewater testing – Wastewater testing helps to understand where the virus is circulating in the population, regardless of whether people have symptoms or have been tested. To date the Island does not have access to the data from wastewater analysis. When this is in place this will form part of our regular data interrogation and surveillance processes. • NHS COVID-19 Application (app) – There is a large amount of data available on the NHS COVID-19 app. Nationally, data shows that over 1.7 million people that use the app across England and Wales have at some point been advised to self-isolate. This data is presented in the Local PowerBI dashboard. • Vaccination data – there are a number of data sources accessed to understand vaccination uptake and inequalities across HIOW, for example and in addition to the publicly available data NIMS and Foundry are accessed. Analysis of these data are used to inform the vaccination roll out programme. • Enhanced Contact Tracing – Common Exposures and Coincidence report data are presented in a PowerBI report to help understand community transmission across our sites. The PHE prioritisation metrics methodology is applied to the data to highlight settings which may require further local investigation. This report is also reviewed by HPT colleagues to ensure a joint up approach.

Further detailed information on surveillance, data integration and information sharing is available in the IWC Incident and Outbreak Control Plan.

2.15 Resourcing

2.15.1 Capacity management

IWC has drawn in specialist skills and professionals from across the Council and our partners to ensure we have sufficient capacity to respond across all aspects of our outbreak control response on the Island. In addition to this, and to enable the Councils’ business as usual

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functions to continue to a high standard, IWC has utilised part of the Government Control Outbreak Management Fund (COMF) grant to support a number of fixed term appointments, harnessing additional skills and capacity across a broad range of departments including Public Health, Adult Health and Care and Communications, as well as capacity in partner organisations.

2.15.2 Management of impacts of the resumption of business as usual activities

Our capacity requirements are regularly reviewed by senior leaders to ensure that resources are deployed where they are most needed both across the Council and with our partners. This is being carefully managed alongside the Government’s published Road Map and consideration being given to enable our ongoing COVID-19 response when resources will return to business-as-usual activities and services and settings reopen. Government COMF grant funding has enabled the continuation of some temporary contracts to continue to support our response to COVID-19, particularly in aspects of our compliance response, and our intention is that this will continue where funding streams are maintained. In addition, as part of its COVID-19 management role, the Health Protection Board oversees broader capacity needs and pressures across the system, and has an agreed escalation route to flag any issues to the Integrated Care Partnership (ICP) system.

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Section 3 Forward Planning

The IWC COVID-19 Local Outbreak Control Plan 2021 needs to evolve as the COVID-19 pandemic continues. As a result this plan is a living document, enabling our response to be agile and respond to change in guidance, policy and legislation as well as to changes in infection levels and impact. IWC will continue to review and update this plan in line with, and in advance of, the four stages outlined in the Government Roadmap published in March 2021 to ensure that our local response remains dynamic to respond to changes in infection rates as society opens up and social mobilisation increases. As part of this we will work with our LRF partners to collaborate and share plans and resources where appropriate to bolster our local response.

The next iteration of the plan will look at some new themes as follows:

• Responding to Variants of Concern (VOC) / Variants under Investigation (VUI). • Action on enduring transmission – further work with partners to understand attitudes and behaviours. • Enhanced Contact Tracing, in partnership with the Public Health England (PHE) Health Protection Team (HPT) - working with HIOW HPT to understand and agree systems of work to enable enhanced contact tracing to take place in alignment with the IWC Local Tracing Service. • Ongoing role of Non-Pharmaceutical Interventions (NPIs) • Interface with vaccines roll-out – further development to support uptake of vaccination among specific communities. This will include further exploration of ‘vaccine confidence’ to ensure that the continued roll out of the vaccination programme targets specific communities and those in higher risk environments. • Activities to enable ‘living with Covid’ (Covid secure) – a continued focus on effective communications campaigns, targeting to specific audiences where insights and data indicate compliance may be lower. Developing systems of working with Hampshire Constabulary and other enforcement agencies in line with the updated Contain Framework • Continued monitoring of local behaviours and intelligence • Determining the recovery aspects and ongoing support, health and care needs for our local community as a consequence of COVID-19.

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And finally…

We believe the steps described in the Plan are critical to preventing the spread of any infection and ultimately saving lives. This will only be achieved through the coordinated efforts of a range of organisations across local and national government, the NHS, Public Health England, businesses and employers, voluntary organisations, and other community partners, and most importantly with the support of Isle of Wight residents.

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Appendix 1 – List of Acronyms

ATS Asymptomatic Testing Site CCG Clinical Commissioning Group CEV Clinically Extremely Vulnerable DPH Director of Public Health DHSC Department of Health and Social Care HCC Hampshire County Council HIOW LRF Hampshire and Isle of Wight Local Resilience Forum HPB Health Protection Board HPT Health Protection Team IPAT Island Partners Activation Teleconference IOWC Isle of Wight Council JBC Joint Biosecurity Centre LOEB Local Outbreak Engagement Board LTS Local Testing Site NPI Non-Pharmaceutical Interventions OCT Outbreak Control Team OCWG Outbreak Control Working Group PHE Public Health England RCG Recovery Coordinating Group RTS Regional Testing Site SCG Strategic Coordinating Group SPL Shielded Patient List ITCG Island Tactical Coordinating Group VOC Variant of Concern VUI Variant under Investigation

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Appendix 2 – Roles and Responsibilities

Organisations/service Key responsibilities Local Authority Functions Public Health • Prepare for and lead the Council Public Health team response to outbreaks. • Coordinate wider proactive work to prevent the spread of infection and minimise risk of outbreaks/clusters of cases. Emergency Planning • Support the Local Authority and system-wide preparation for and response to outbreaks. • Facilitate and support the council’s response arrangements in line the council’s Emergency Response Plan • Facilitate and support the council’s commander’s participation in line with the Island Resilience Forum/HIOW Local Resilience Forum Emergency Response Arrangements Adult Social Care • Support the response with a focus on higher risk settings and vulnerable groups. Children’s Services • Provide advice to education settings (using national guidance and local public health recommendations) to prevent the spread of infection and minimise risk of outbreaks/clusters. • Liaise with PHE SE HPT (HIOW) and the Council Public Health team to support the investigation and management of outbreaks in education settings. • Ensure a focus on children and young people that will be particularly vulnerable as a result of the outbreak and response i.e. vulnerable children and young people needing to self-isolate. Leisure and Sport • Coordinate wider proactive work to prevent the spread of infection and minimise risk of outbreaks/clusters of cases in cultural and leisure facilities. • Liaise with PHE SE HPT (HIOW) and the Council Public Health team to support the investigation and management of outbreaks.

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Communications • Preparing and delivering the Communications Plan, which includes proactive and reactive communications with all relevant settings, agencies and the public. Environmental Health* • The EH Team sits within the Regulatory Services Department • Regulatory and enforcement role to businesses preventing the spread of infection and minimising the risk of outbreaks/clusters of cases. • Additional support in the event of the escalation of a local outbreak that requires further local capacity i.e. for contact tracing and interviewing. • Enforcement of various legislation related to the control of disease or health and safety at work. Private Sector Housing • This team also sits within the Regulatory Services Department • Coordinate wider proactive work to prevent the spread of infection and minimise risk of outbreaks/clusters of cases in key higher risk settings, such as hostels and houses in multiple occupation (HMOs). • Liaise with PHE SE HPT (HIOW) and the Council Public Health team to support the investigation and management of outbreaks. • Ensure a focus on people that will be particularly vulnerable as a result of the outbreak and response. Partner Organisations PHE SE HPT (HIOW) * • Discharge the responsibilities of PHE via the SE HPT (HIOW). NHS England and NHS • Provide strategic direction to local commissioners and Improvement* providers of NHS funded care. IOW CCG * • Coordinate wider proactive work to prevent the spread of infection and minimise risk of outbreaks/clusters of cases in healthcare settings and services i.e. primary care. • Take local action (e.g. testing and treating) to assist the management of outbreaks, and to provide services for prevention, diagnosis and treatment of illness, under the Health and Social Care Act 2012.

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Infection Prevention Control- • Provide specialist infection control advice to organisations and Via the IOW CCG settings to prevent the spread of infection and minimise risk of outbreaks/clusters of cases, and to inform the response. IOW NHS Trust • Deliver the Trust’s Infection Control Plan in relation to COVID- 19. • Liaise with PHE SE HPT (HIOW) in the event of an outbreak. Police • To support the response to an outbreak through the implementation of relevant policies or powers. • The Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 with regard to movement restrictions Voluntary Sector • Coordinate and provide support to residents with a particular focus on those that are vulnerable because they are shielding or self-isolating. Town and Parish Councils • Supporting vulnerable people and communities and promoting key messages in the event of a COVID-19 incident or outbreak

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